Page 3 - 2018HomecareHighlights

Advocacy Efforts Bring Deemed Eligibility within Reach

This year, PHA advocates took on the challenge of passing legislation to permit homecare and home health
agencies to begin serving Medicaid waiver participants while they wait for their financial eligibility paperwork to be

processed by the county. This “deemed eligibility” would help make home-based care accessible for applicants who

sometimes wait up to nine months for services to be approved, while a nursing home is able to admit an applicant

right away and be paid later once the eligibility determination is complete. PHA drafted legislation to allow

retroactive payment for homecare services for up to 60 days

to help even the playing field. The legislation was introduced

at the end of 2017 and passed the House and Senate, yet

necessary amendments delayed the bill’s final approval and

time ran out.

Member advocates sent a record number of messages to

their elected officials. The good news is that a new legislative

session will begin in 2019 and PHA will once again introduce
similar le gislation. Everyone knows that care at home should

be the first choice for everyone applying for Medicaid
coverage .

FINGER ON THE PULSE:

PHA at Work for YOU! Homecare Licenses Per Year

• Weekly meetings with OLTL officials
on implementation of CHC

• Provider representatives on the

Managed Long-Term Services and

Supports (MLTSS) Subcommittee of

the Medical Assistance Advisory

Committee (MAAC), which oversees

implementation of CHC

• Member of the Long-Term Care

MAAC, which oversees homecare

serv ices provided outside of CHC, Source: DOH 2016 Provider Statistics

enrollment and eligibility issues Competition is Fierce

• Partnership for Medicaid Home- PHA Membership Sets YOU Apart!

Based Care, national

• Department of Human Services’

eHealth Advisory Board DOH reported

• Quarterly Meetings with DOH

Surveyor Team
2,128

licensed homecare providers statewide in 2018